Vitellogenin Dynamics and Reproductive Morphology at Sexual Maturity of Philippine Mallard (Anas Platyrhynchos Domesticus L) Fed with Zinc Supplemented Diet

The vitellogenin (Vtg) is a precursor for the synthesis of egg yolk protein. Feeding with zinc-supplemented diet is hypothesized to increase the circulating Vtg thereby enhancing reproductive development. A total of 80 ducks,aged 16 weeks old, were randomly assigned to treatment groups; namely: group A with 40 ducks fed with 30 ppm zinc-supplemented diet (zinc positive) and group B with 40 ducks fed with no added zinc (zinc negative). Thecirculating Vtg at sexual maturity (155.11±10.83 days old) were determined from the blood sera. The sera were assayed for Vtg in duplicate using 96–well microplate and read the optical density at 415nm. The zinc concentrationof the samples was calculated using the nonlinear regression =OD = a x [Zn2+] / (b + [Zn2+]. Results show that the circulating Vtg in the blood sera of ducks at sexual maturity were 0.69±0.07 Gg Zn dL-1. The feeding of zinc-treateddiet had no significant influenced on the concentration of circulating Vtg. There was also insignificant difference in the reproductive morphology of ducks fed with or without added zinc. The Vtg concentration had no correlation withreproductive parameters but found to be positively correlated with liver weight (H=0.21) and negatively correlated with body weight (H = -0.24)

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Acetylcholinesterase enzyme activity in carp brain and muscle after acute exposure to diafuran Atividade da enzima acetilcolinesterase em cérebro e músculo de carpas após exposição aguda ao diafuran

Sublethal adverse effects may result from exposure of aquatic organisms to insecticides at environmentally relevant concentrations. Fingerlings of the common carp (Cyprinus carpio, Linnaeus, 1758), grass carp (Ctenopharyngodon idella, Valenciennes, 1844), and bighead carp (Aristichthys nobilis, Richardson, 1845) were exposed to diafuran, an insecticide widely used during rice cultivation in Southern Brazil. The aim of this study was to verify the relationship between the lethal concentration (LC50) of diafuran and the acetylcholinesterase (AChE) activity in brain and muscle tissues of these species as a possible early biomarker of exposure to this insecticide. LC50 was determined for fish exposed to diafuran concentrations during 96 h (short term): common carp: control, 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 mg L-1; grass carp: control, 1.0, 2.0, 3.0 and 3.5 mg L-1 and, bighead carp: control, 0.5, 1.0, 1.5, 2.0, 3.0 and 4.0 mg L-1, as well as the determination of AChE at concentrations near LC50 for these species. LC50 values (nominal concentrations) were 1.81 mg L-1 for the common carp, 2.71 mg L-1 for the grass carp and, 2.37 mg L-1 for the bighead carp. All carps exposed to diafuran were lethargic (lower concentrations) or immobile. Diafuran inhibited the acetylcholinesterase activity in brain (~38%) and muscle (~50%) of all species. Muscle of bighead carp under control treatment showed higher specific AChE activity than brain (14.44 against 5.94 µmol min-1 g protein-1, respectively). Concentrations of diafuran used for rice cropping may affect Cyprinus carpio, Ctenopharyngodon idella and Aristichthys nobilis behaviors and the AChE activities in brain and muscle of these species may be an early biomarker of toxicity of this insecticide.<br>Exposição a inseticidas em concentrações elevadas no ambiente podem ocasionar efeitos adversos subletais em organismos aquáticos. Alevinos de carpa húngara (Cyprinus carpio, Linnaeus, 1758), carpa capim (Ctenopharyngodon idella, Valenciennes, 1844) e carpa cabeça grande (Aristichthys nobilis, Richardson, 1845) foram expostos ao diafuran, um inseticida utilizado na cultura do arroz no sul do Brasil. O objetivo deste estudo foi verificar a relação entre concentração letal mediana (CL50) do diafuran e a atividade da enzima acetilcolinesterase (AChE) em cérebro e músculo dessas espécies, como um possível biomarcador inicial da exposição a este inseticida. A CL50 foi determinada com peixes expostos a concentrações de diafuran em 96 h: carpa húngara: controle; 0,5; 1,0; 1,5; 2,0; 2,5 e 3,0 mg L-1; carpa capim: controle; 1,0; 2,0; 3,0 e 3,5 mg L-1 e carpa cabeça grande: controle; 0,5; 1,0; 1,5; 2,0; 3,0 e 4,0 mg L-1, bem como a determinação da AChE em concentrações próximas da CL50 para essas espécies. Valores de CL50 (concentrações nominais) foram de 1,81 mg L-1 para carpa húngara, 2,71 mg L-1 para carpa capim e 2,37 mg L-1 para carpa cabeça grande. Todas as carpas expostas ao diafuran estavam letárgicas (menores concentrações) ou imóveis. Diafuran inibiu significativamente a atividade da AChE em cérebro (~38 %) e músculo (~50 %) de todas as espécies estudadas. Atividade da AChE em músculo para carpa cabeça grande foi mais alta que cérebro (14,44 contra 5,94 µmol min-1 g proteína-1, respectivamente). Este estudo demonstrou que concentrações de diafuran utilizadas na cultura do arroz podem afetar o comportamento de Cyprinus carpio, Ctenopharyngodon idella e Aristichthys nobilis, e a atividade da acetilcolinesterase cerebral e muscular pode ser um biomarcador inicial de toxicidade deste inseticida